Journal of Multidisciplinary Healthcare最新文献

{"title":"The Knowledge-Attitude-Behavior Paradox in E-Cigarette Adoption Among University Students at Northern Border University, Saudi Arabia.","authors":"Ibrahim Naif Alenezi, Fathia Ahmed Mersal, Heba Ahmed Osman Mohamed, Fathia Gamal El Said, Fadiyah Jadid Alanazi, Lobna Mohamed Abu-Negm, Taghreed Hussien Aboelola, Abdulhamid Gharib Alrwili","doi":"10.2147/JMDH.S578360","DOIUrl":"https://doi.org/10.2147/JMDH.S578360","url":null,"abstract":"<p><strong>Background: </strong>The proliferation of e-cigarette use among university students presents a critical public health challenge, yet the mechanisms driving adoption in non-Western sociocultural contexts remain inadequately theorized.</p><p><strong>Purpose: </strong>Guided by the Social Cognitive Theory and the Theory of Planned Behavior, this study investigated the prevalence and predictors of e-cigarette use among university students at Northern Border University in Saudi Arabia.</p><p><strong>Material and methods: </strong>A cross-sectional survey of 670 students assessed knowledge, attitudes, and usage behaviors, with predictors identified via multivariable logistic regression.</p><p><strong>Results: </strong>The prevalence of current use was 20.6% (138/670), with a significant gender disparity where female students had lower odds of use (adjusted OR = 0.334**; 95% CI: 0.203-0.550**). A striking knowledge-attitude-behavior paradox emerged: while 77.6% (520/670) acknowledged addiction potential, substantial gaps in knowledge about respiratory risks (only 45%, 301/670) and nicotine content (35%, 234/670) persisted. Critically, medical students, despite having superior knowledge (53.2%, 141/265 vs 28.4%, 115/405 among non-medical students), exhibited only moderately more protective attitudes (61.5% vs 78.5% disapproving). More favorable attitudes significantly predicted current use (adjusted OR = 1.040 per one-point increase**; 95% CI: 1.008-1.073**), confirming the mediating role of attitudes.</p><p><strong>Conclusion: </strong>These findings indicate that e-cigarette adoption is a socially embedded behavior shaped by gender norms and educational contexts, challenging information-deficit models. This underscores the necessity for theory-driven, multilevel interventions that address cognitive, affective, and normative determinants of behavior to inform culturally sensitive prevention strategies and campus policies.</p>","PeriodicalId":16357,"journal":{"name":"Journal of Multidisciplinary Healthcare","volume":"19 ","pages":"578360"},"PeriodicalIF":2.4,"publicationDate":"2026-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12927766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147284233","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Best Evidence Summary on Early Exercise for Prevention of ICU-Acquired Weakness: An Evidence-Based Synthesis.","authors":"Xi Bai, Chunmei Gu, Yanli Li, Xiaobo Jin, Jinmei Liu, Chuan Guo","doi":"10.2147/JMDH.S574831","DOIUrl":"https://doi.org/10.2147/JMDH.S574831","url":null,"abstract":"<p><strong>Purpose: </strong>This study systematically aimed to identify and synthesize the highest-quality available evidence regarding the preventive impact of early exercise interventions on intensive care unit acquired weakness (ICUAW) in critically ill adults.</p><p><strong>Methods: </strong>Utilizing the evidence-based 6S model, we conducted a comprehensive literature review across multiple databases. The review concentrated on evidence related to early exercise in intensive care unit (ICU) patients, specifically evaluating early assessment strategies, risk management, appropriate intensity and prescription of exercise interventions, safety considerations, and the role of multidisciplinary collaboration. The literature search was performed from database inception to April 30, 2025. Two independent researchers evaluated literature quality and extracted data, systematically synthesizing evidence from studies that met predefined inclusion criteria.</p><p><strong>Results: </strong>A total of 24 studies were included: 6 clinical guidelines, 8 randomized controlled trials, 7 systematic reviews, and 3 expert consensus statements. Taken together, current evidence converges on a key practice approach that integrates routine early assessment of muscle strength and functional status, risk-stratified and progressively advanced exercise, individualized titration of exercise intensity and frequency according to hemodynamic stability and level of consciousness, explicit safety thresholds and stopping criteria, and delivery by a coordinated multidisciplinary team of nurses, physicians, and rehabilitation professionals.</p><p><strong>Conclusion: </strong>This review synthesizes high-quality evidence supporting the use of targeted early exercise interventions to prevent intensive care unit-acquired weakness (ICUAW), thereby providing an evidentiary foundation for clinicians to develop individualized intervention plans and to improve both short-term clinical outcomes and long-term recovery in critically ill ICU patients. Future research should, within a multidisciplinary team framework, conduct large-scale, multicenter cohort studies to determine the optimal initiation timing and dosage of early exercise, with the ultimate aim of further reducing the incidence of ICUAW and optimizing patient prognosis.</p><p><strong>Trial registration: </strong>This study was based on the evidence summary reporting specifications of the Fudan University Center for the Evidence-based Nursing, the register name is \"Best evidence summary on early exercise for the prevention of ICU-acquired weakness in critically ill patients\", the registration number is \"ES20257998\".</p>","PeriodicalId":16357,"journal":{"name":"Journal of Multidisciplinary Healthcare","volume":"19 ","pages":"574831"},"PeriodicalIF":2.4,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12927820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147284182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application Effect of Colostrum Oral Immunotherapy in the Early Stage of Mechanical Ventilation for Very Low Birth Weight Preterm Infants.","authors":"Liduan Li, Yanzhu Lin, Ting Huang, Chunyan Lin","doi":"10.2147/JMDH.S570953","DOIUrl":"https://doi.org/10.2147/JMDH.S570953","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate the impact of C-OIT on outcomes of VLBW preterm infants during early mechanical ventilation.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on preterm infants with birth weight <1500g who received mechanical ventilation and were admitted to the Pediatric Department of the Second Affiliated Hospital of Fujian Medical University from December 2022 to December 2024. Participants were divided into intervention group (received C-OIT) and control group (received normal saline oral immunotherapy). Propensity score matching (PSM) was applied to balance baseline characteristics between groups, with comparisons made regarding primary outcomes (intervention efficacy, feeding capacity, feeding effectiveness, immune function) and secondary outcomes (developmental level, adverse reactions).</p><p><strong>Results: </strong>After PSM, 50 cases were included in each group. Baseline characteristics showed no statistically significant differences between groups (P>0.05), ensuring comparability. The intervention group exhibited shorter mechanical ventilation duration and hospital stay compared to the control group. Post-treatment scores and total scores of PIOFRA were higher in the intervention group. The intervention group showed shorter initiation time for oral feeding, complete oral feeding time, and birth weight recovery time. Levels of secretory immunoglobulin A (sIgA) and lactoferrin in airway secretions and urine were elevated in the intervention group post-treatment. Post-intervention body weight, head circumference, and body length were greater in the intervention group. The incidence of adverse reactions was significantly lower in the intervention group. All intergroup differences were statistically significant (P<0.05).</p><p><strong>Conclusion: </strong>Colostrum Oral Immunotherapy demonstrates significant application effects in early mechanical ventilation for very low birth weight preterm infants. It not only shortens mechanical ventilation duration but also improves feeding tolerance and effectiveness, enhances immune function to promote infant development, while reducing the occurrence of clinical adverse reactions.</p>","PeriodicalId":16357,"journal":{"name":"Journal of Multidisciplinary Healthcare","volume":"19 ","pages":"570953"},"PeriodicalIF":2.4,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12927730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147284179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Usability Evaluation of a Serious Game for Dietary Health Education in Gestational Diabetes Mellitus: A Mixed-Methods Study Based on the SGDA Framework.","authors":"Chunying Xie, Yiyi Xu, Fangying Huang, Siqi Shi, Chen Liu, Jingjing Xiao, Shu Cai","doi":"10.2147/JMDH.S580073","DOIUrl":"https://doi.org/10.2147/JMDH.S580073","url":null,"abstract":"<p><strong>Purpose: </strong>To develop a serious game for dietary health education in gestational diabetes mellitus (GDM) and conduct its usability evaluation, so as to provide a new auxiliary tool for dietary health education among GDM patients.</p><p><strong>Patients and methods: </strong>Guided by the Serious Game Design Assessment (SGDA) framework, the script of the serious game was formulated by integrating evidence and literature, and the content of the script was revised through expert group meetings. After optimizing the game script, cooperation with software engineers was carried out to complete the development of the serious game. GDM patients from the obstetric outpatient department were selected as research subjects using the convenience sampling method, and usability evaluation was conducted by adopting the think-aloud method and the System Usability Scale (SUS) respectively.</p><p><strong>Results: </strong>A mini-program of the serious game for GDM dietary health education was developed, with modules including Food Matching Elimination, Glycemic Index (GI) Classification Master, Meal Preparation Game, Gestational Sugar Control Gourmet, and Nutritious Plate Challenge. In the think-aloud test, the effectiveness of 3 GDM patients in completing the target tasks was (87.5%, 75.0%, 87.5%) respectively. Two themes regarding the game user experience were extracted: 1) the game content has practical value; 2) users can obtain an interesting emotional experience. The total SUS score of the serious game assessed by 30 GDM patients was (79.50±4.17), indicating that the serious game has good usability.</p><p><strong>Conclusion: </strong>The serious game for GDM dietary health education has practicality and interest. It can help patients learn GDM-related dietary knowledge and can be used as an auxiliary tool for GDM dietary health education.</p>","PeriodicalId":16357,"journal":{"name":"Journal of Multidisciplinary Healthcare","volume":"19 ","pages":"580073"},"PeriodicalIF":2.4,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12922955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147271447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cox Proportional Hazards Model Analysis of Survival Among Tuberculosis Patients Under Treatment in Mbuji-Mayi, Democratic Republic of the Congo.","authors":"Moise Kanyiki Katala, Michel Kabamba Nzaji, Félicien Ilunga Ilunga","doi":"10.2147/JMDH.S580987","DOIUrl":"https://doi.org/10.2147/JMDH.S580987","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB) remains one of the leading causes of death in Mbuji-Mayi, as in many other cities worldwide. Despite the availability of free treatment, TB continues to spread in the city due to weaknesses in health system performance, socioeconomic conditions, and limited financial resources. This study aimed to contribute to reducing TB-related mortality in Mbuji-Mayi by identifying risk factors affecting the survival of patients undergoing anti-tuberculosis treatment.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted among tuberculosis patients registered and followed up in the TB treatment centers (CDTs) of Mbuji-Mayi between January 1 and December 31, 2024. Data were collected from patient records and treatment registers. A total of 1,633 cases were included in the analysis. Survival probabilities were estimated using the Kaplan-Meier method, and factors associated with survival were identified using the Cox proportional hazards model.</p><p><strong>Results: </strong>Multivariate analysis showed that comorbid conditions such as HIV and diabetes were significantly associated with mortality among TB patients (adjusted Hazard Ratio [aHR] = 4.65; <i>p</i> = 0.003). Drug resistance was strongly associated with reduced survival time (aHR = 12.12; <i>p</i> < 0.001). Male sex was more exposed to mortality compared to females (aHR = 9.94; <i>p</i> = 0.026), and tobacco or alcohol use was also a significant risk factor associated with decreased survival (aHR = 3.31; <i>p</i> = 0.046).</p><p><strong>Conclusion: </strong>The overall survival probability remained high, ranging from 99.7% in the first month to 98.8% in the fifth month of treatment. Most deaths occurred early during therapy. Mortality among TB patients in Mbuji-Mayi is mainly influenced by comorbidity, drug resistance, male sex, and tobacco or alcohol consumption. Strengthening early detection, adherence support, and management of comorbid conditions could improve patient survival.</p>","PeriodicalId":16357,"journal":{"name":"Journal of Multidisciplinary Healthcare","volume":"19 ","pages":"580987"},"PeriodicalIF":2.4,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12927859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147284209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Online Pilates Program for People with Hypermobility: A Pragmatic Clinical Trial Looking at Function, Interoception, Kinesiophobia, and Physical Activity Levels.","authors":"Leslie N Russek, Jeannie Di Bon, Anthony Herbland, Cheyenne Vivlamore Zion Higgins, Tiffany R Jandrew, Alison M Adams, Jane Simmonds","doi":"10.2147/JMDH.S564972","DOIUrl":"https://doi.org/10.2147/JMDH.S564972","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluated whether an independent, online modified Pilates program alters function, interoception (internal body awareness), activity levels, and kinesiophobia (fear of movement) in people with symptomatic joint hypermobility.</p><p><strong>Patients and methods: </strong>This pragmatic clinical trial included and exercise group that did 8 weeks of modified Pilates and an 8-week waitlist control group. People with symptomatic hypermobility were asked to do an independent, online Pilates program designed specifically for people with hypermobility; each module was about 25 minutes, and participants were asked to do at least 3 days/week. Outcome measures included the Bristol Impact of Hypermobility (BIoH), International Physical Activity Questionnaire (IPAQ), Revised Body Awareness Questionnaire (BARQ), and Tampa Scale of Kinesiophobia (TSK). Clinical Trial # NCT07118865.</p><p><strong>Results: </strong>A total of 420 participants completed questionnaires at 8 weeks: 200 completed 8 weeks of Pilates and 220 were on a waitlist. The Pilates group demonstrated statistically significant improvements in BIoH, BARQ, and TSK immediately after the intervention (p<0.001 for each) and compared to the control group (p<0.001 for each). Improvements in the Pilates group remained statistically significant at 6 months. IPAQ did not change for any group.</p><p><strong>Conclusion: </strong>This online Pilates program for people with symptomatic hypermobility improved BIoH, BARQ, and TSK, though changes were modest. The exercises did not improve IPAQ. Online exercise may provide a cost-effective way to encourage life-long activity in people with hypermobility. Limitations include the inability to monitor performance of the Pilates, high drop-out rates, and the inability to control for changes in other treatments patients may have received.</p>","PeriodicalId":16357,"journal":{"name":"Journal of Multidisciplinary Healthcare","volume":"19 ","pages":"564972"},"PeriodicalIF":2.4,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12927770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147284128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetes Distress in Adults with Type 2 Diabetes and Multimorbidity: A Scoping Review.","authors":"Muhammad Afiif Aziz, Neti Juniarti, Titis Kurniawan, Reni Afriana","doi":"10.2147/JMDH.S588965","DOIUrl":"https://doi.org/10.2147/JMDH.S588965","url":null,"abstract":"<p><strong>Background: </strong>Diabetes distress is a distinct psychological construct often conflated with depression in adults with Type 2 Diabetes Mellitus (T2DM) and multimorbidity. Current literature lacks a unified synthesis explaining how \"therapeutic competition\", where managing multiple conditions creates conflicting self-care demands, and cumulative regimen complexity specifically drive distress in this population.</p><p><strong>Objective: </strong>This scoping review systematically maps the biopsychosocial determinants of diabetes distress in adults with T2DM and multimorbidity to inform integrated, patient-centered interventions.</p><p><strong>Methods: </strong>A systematic search was conducted across PubMed/MEDLINE, Scopus, and EBSCOhost up to July 2025, following PRISMA-ScR guidelines. Peer-reviewed English studies examining diabetes distress in adults (≥18 years) with T2DM and multimorbidity were included. Evidence was thematically synthesized using a biopsychosocial framework.</p><p><strong>Results: </strong>Of 269 records, 17 studies met the inclusion criteria. Thematic synthesis identified a synergistic interplay across four domains. Clinically, distress was driven primarily by treatment complexity (insulin regimens, polypharmacy) rather than disease duration, and was linked to poor glycemic control. Psychologically, distress emerged as a distinct mediator between depression and self-management. Behavioral challenges included medication non-adherence and physical inactivity. Notably, sociodemographic risks revealed significant cultural divergence: while socioeconomic disadvantage was universal, marital status acted as a protective buffer in Western cohorts but a source of caregiving strain in specific non-Western contexts.</p><p><strong>Conclusion: </strong>Diabetes distress in multimorbidity is a biopsychosocial phenomenon driven by therapeutic competition and context-dependent social dynamics, rather than chronicity alone. Effective management requires a paradigm shift toward integrated care that prioritizes routine screening for high-risk profiles and culturally adapted support systems.</p>","PeriodicalId":16357,"journal":{"name":"Journal of Multidisciplinary Healthcare","volume":"19 ","pages":"588965"},"PeriodicalIF":2.4,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12922951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147271424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application and Delphi Validation of an Omaha System-Based Evaluation Index for Post-PCI Rehabilitation Nursing.","authors":"Lili Wu, Yahui Gong, Xueli Liu, Yaqian Ning, Jianlan Song, Zhifu Zhang, Hairong Zhou, Haiyan Xiong","doi":"10.2147/JMDH.S559427","DOIUrl":"https://doi.org/10.2147/JMDH.S559427","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to develop an evaluation index system based on the Omaha System to identify postoperative rehabilitation nursing problems in patients after percutaneous coronary intervention (PCI). This evaluation system aims to facilitate the timely identification of nursing problems and enhance the reliability of nursing interventions during postoperative rehabilitation.</p><p><strong>Methods: </strong>Rehabilitation nursing problems were identified through a comprehensive literature review and case analysis, considering both the physical and psychological characteristics of post-PCI patients. These problems were classified and organized according to the Omaha System. From September 2020 to February 2021, Delphi consultations were conducted with experts in China to finalize the evaluation indicators.</p><p><strong>Results: </strong>After two rounds of expert consultation, the authority coefficients of the experts were 0.858 and 0.875, and Kendall's W coefficients were 0.194 and 0.150, respectively (both <i>P</i> < 0.01), indicating consensus. The final evaluation index system comprised 4 first-level indicators (domains), 21 second-level indicators (nursing problems), and 130 third-level indicators (specific symptoms/signs).</p><p><strong>Conclusion: </strong>The Omaha System-based evaluation index developed in this study offers a clinically applicable framework for identifying and managing rehabilitation nursing problems in PCI patients. Supporting comprehensive and systematic assessment provides nurses with clear guidance for problem recognition, individualized care planning, and outcome monitoring. Its application has the potential to enhance care consistency, improve patient recovery, and promote evidence-based nursing decision-making, thereby contributing to improved quality of post-PCI rehabilitation care in clinical practice.</p>","PeriodicalId":16357,"journal":{"name":"Journal of Multidisciplinary Healthcare","volume":"19 ","pages":"559427"},"PeriodicalIF":2.4,"publicationDate":"2026-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12911969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146220052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Nomogram Predicting the Risk of Anxiety in Third-Trimester pregnancy in Pregnant Women with CTDs.","authors":"Shu Xu, Xiuli Zhong, Xingfeng Cai, Jiawen Wu, Hanxiao Wang, Shiwen Ni, Mei Yang, Chen Dong, Zhifeng Gu","doi":"10.2147/JMDH.S559273","DOIUrl":"https://doi.org/10.2147/JMDH.S559273","url":null,"abstract":"<p><strong>Purpose: </strong>Connective tissue diseases (CTDs) is a group of autoimmune diseases that damage multiple systems and can cause anxiety in pregnant women. The aim of this study was to identify risk factors of anxiety during third-trimester pregnancy among CTDs patients and to develop a predictive model to improve clinical outcomes.</p><p><strong>Patients and methods: </strong>A total of 226 pregnant women with CTDs and 226 normal pregnant women were enrolled in this study during third-trimester pregnancy. This study analyzed risk factors for late pregnancy anxiety in pregnant women with CTDs using binary logistic regression. The probability of anxiety occurrence is predicted by nomogram and further validated by decision curve analysis (DCA), receiver operating characteristic curve (ROC), calibration curve.</p><p><strong>Results: </strong>Anxiety levels were found to be significantly higher in pregnant women with CTDs compared to the control group (4.64±2.92 <i>VS</i> 3.97±2.44, <i>P</i> = 0.008). These results suggest that anxiety plays a critical role during the third trimester of pregnancy in this particular population. A total of 33 pregnant women with CTDs (14.6%) reported anxiety in third-trimester pregnancy. Risk factors associated with anxiety in third-trimester pregnancy include sleep disturbances (OR=4.226, 95CI% = 1.508-11.843), pregnancy stress (OR=1.121, 95CI% = 1.069-1.175) and family dysfunction (OR = 4.710, 95CI% =1.004-22.184).</p><p><strong>Conclusion: </strong>The nomogram has clinical utility and robustly predicts the associated anxiety model. During third-trimester pregnancy, sleep disturbances, pregnancy stress, and family dysfunction increase the risk of anxiety in pregnant women with CTDs, which can result in an increased likelihood of emergency cesarean sections and more postpartum blood loss at 2 hours.</p>","PeriodicalId":16357,"journal":{"name":"Journal of Multidisciplinary Healthcare","volume":"19 ","pages":"559273"},"PeriodicalIF":2.4,"publicationDate":"2026-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12915432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146227053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When and How Grid-Based Information Management for VTE Prevention: Boundary Conditions and Configurational Pathways from a Mixed-Methods Study.","authors":"Chunyan Wang, Haiyan Li, Shiyuan Chen, Min Zhou, Tian Ding","doi":"10.2147/JMDH.S588156","DOIUrl":"https://doi.org/10.2147/JMDH.S588156","url":null,"abstract":"<p><strong>Background: </strong>Venous thromboembolism (VTE) is a significant cause of preventable morbidity and mortality among hospitalized patients. Although grid-based information management systems have shown effectiveness in VTE prevention, the boundary conditions and configurational pathways leading to optimal outcomes remain unclear.</p><p><strong>Objective: </strong>To investigate the impact mechanism of grid-based information management on VTE prevention effectiveness, identify boundary conditions of moderating effects, and explore configurational pathways leading to high prevention outcomes.</p><p><strong>Methods: </strong>A mixed-methods study design was employed. A total of 119 hospitalized patients from Affiliated Hospital of North Sichuan Medical college were enrolled between January and December 2024, with 58 patients in the control group (traditional management) and 61 in the intervention group (grid-based information management). The Johnson-Neyman (J-N) technique was used to identify the boundary conditions of nurses' VTE knowledge and departmental collaboration on intervention effectiveness. Fuzzy-set qualitative comparative analysis (fsQCA) was employed to identify configurational pathways leading to high VTE prevention outcomes.</p><p><strong>Results: </strong>The intervention group demonstrated significantly higher VTE risk assessment completion rates (86.9% vs 63.8%, absolute difference 23.1%, 95% CI 8.7-37.5%, P<0.01), prevention measure implementation rates (90.2% vs 58.6%, absolute difference 31.6%, 95% CI 17.2-46.0%, P<0.01), and lower VTE incidence (3.3% vs 8.6%, absolute risk reduction 5.3%, 95% CI 0.4-10.2%, NNT=19, 95% CI 10-250, P=0.032). J-N analysis revealed that the positive effect of grid-based information management on VTE risk assessment became significant when nurses' VTE knowledge scores reached ≥42 points (P<0.05), and the effect on prevention measure implementation became significant when departmental collaboration scores reached ≥3.4 points (P<0.05). FsQCA identified three configurational pathways leading to high VTE prevention outcomes: technology-driven, collaboration-driven, and comprehensive support pathways, with an overall solution consistency of 0.892 and coverage of 0.684.</p><p><strong>Conclusion: </strong>Grid-based information management effectively improves VTE prevention outcomes, but its effectiveness is contingent upon nurses' knowledge levels and departmental collaboration. Multiple equifinal pathways exist to achieve high VTE prevention outcomes, providing evidence for tailored implementation strategies.</p>","PeriodicalId":16357,"journal":{"name":"Journal of Multidisciplinary Healthcare","volume":"19 ","pages":"588156"},"PeriodicalIF":2.4,"publicationDate":"2026-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12912151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146220074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}